Reassurance from a nurse could have benefitted Gloria Smith ("Communicating Competence," Viewpoint, May). In Principles and Practice of Nursing, sixth edition, Virginia Henderson and Gladys Nite cite research by James K. Skipper and others on the "expressive function of communication," whereby "patients used this type of communication as a sign that not only were their nurses and physicians dedicated and interested in their care and cure and would not reject them, but also that these persons were technically qualified, possessing the knowledge and skill to get them well." Such research, synthesis, and exposition as is used in the textbook may not receive sufficient emphasis as student nurses spend their increasingly scarce time pursuing purely technical competence.

I last saw Smith addressing an International Council of Nurses congress, where she cautioned the world's nurses not to emulate what is done in America. Sadly, her Viewpoint reinforces that perspective. She deserves better-as do all of our patients.

Edward J. Halloran, PhD, MPH, RN

Chapel Hill, NC